The silver caps placed on children’s teeth are formally known as Stainless Steel Crowns (SSCs). These are pre-formed, durable metal shells used by pediatric dentists as a protective covering for a primary, or baby, tooth. The crown is designed to entirely cover the visible part of a tooth that has been severely damaged or weakened. The primary purpose of placing an SSC is to save a compromised tooth too damaged for a simple filling, ensuring it remains functional until the permanent tooth naturally erupts.
Why Dentists Prefer Stainless Steel Crowns Over Fillings
Dentists recommend stainless steel crowns when the extent of decay is too great for a traditional silver or composite filling. A filling is best suited for small to moderate decay limited to one surface of the tooth. Large, multi-surface cavities compromise too much of the tooth structure, making a filling prone to premature failure, fracturing, or leaking, which allows decay to return quickly.
SSCs are more durable than large fillings and offer full coverage that protects the entire chewing surface and sides of the tooth. This full-coverage restoration is important for molars, which bear the brunt of chewing forces. SSCs are the restoration of choice following a pulpotomy, a procedure where infected pulp tissue is removed from the crown of the tooth.
After this nerve treatment, the remaining tooth structure is fragile and requires the complete seal that an SSC provides to prevent re-infection. Maintaining the primary molars is important because they act as natural space holders, guiding the permanent teeth into their correct positions. Premature loss of a baby tooth due to filling failure can lead to space loss, potentially causing crowding and the need for orthodontic treatment later.
The ease of placement and superior longevity of SSCs makes them a practical choice for younger children. These children may struggle to cooperate for the precise, moisture-sensitive technique required for large composite fillings.
What Happens During the Placement Procedure
The process for placing a stainless steel crown is completed in a single dental visit, which is beneficial for young patients. The dentist first prepares the tooth by removing all existing decay and gently shaping the tooth structure. Minimal tooth reduction is required compared to other types of crowns, helping to preserve the remaining natural tooth.
The dentist selects a pre-fabricated crown from a kit containing various sizes and shapes. They choose the smallest crown that correctly fits the prepared tooth. This sizing ensures the margins of the crown extend just beneath the gum line, creating a seal before the crown is permanently cemented onto the tooth.
The SSC is a long-lasting restoration for a temporary tooth, not a permanent solution. It remains in place, acting as a functional tooth, until the primary tooth beneath it begins to naturally loosen. When the permanent tooth erupts, it pushes the primary tooth and the stainless steel crown out together.
Other Options for Treating Severe Tooth Decay
While stainless steel crowns are effective and economical, parents often inquire about alternatives to the metallic silver appearance, especially for visible teeth. The primary aesthetic alternative is the Zirconia crown, a tooth-colored, ceramic option. Zirconia crowns offer a natural, white appearance and are durable, though they are more expensive and require meticulous tooth preparation.
For small areas of decay on a single surface, a traditional filling remains the standard treatment. If decay is too extensive for an SSC and the tooth cannot be saved even with nerve treatment, the only remaining option is extraction. If a baby tooth is removed early, a space maintainer must be placed immediately to prevent adjacent teeth from drifting into the open space, ensuring the permanent tooth has room to emerge correctly.